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Glitches hit Choose and Book

Technical problems and increasing restrictions on referrals are proving major barriers to GPs using Choose and Book, writes Helen Crump.

Latest figures from strategic health authorities show fewer than one-third of GP referrals were made using the system in November, well below Government targets.

Even the best-performing area, the North-East, was only at 39 per cent against a 70 per cent target. East of England SHA was lowest at 20 per cent.

Research on GPs' experiences of using the system, released this week, found many were being deterred because they were often barred from referring to a named consultant or a local hospital. GPs 'resented' the restrictions, the study by the King's Fund concluded, and believed they 'struck at the core of the relationship between GP and consultant'.

Dr Rebecca Rosen, GP and

report author, said GPs felt aggrieved they were not able to make decisions based on their knowledge of specific consultants. She said: 'I think some patients really value that input from their GP and that's what the choice decision negotiations are meant to be about.'

The report called for the

option to refer to a named

clinician to be a default setting.

It also concluded that policies should be set up to ensure referral management centres complemented advice from GPs.

Dr Rosen said technical difficulties were still a problem and the system frequently crashed. She said: 'That would explain the relatively low uptake.'

In a letter to Pulse, Dr Mark Davies, Choose and Book primary care medical director, said the system allowed named consultant referrals, but many PCTs were stopping GPs doing so because of waiting time targets.

He wrote: 'The reason these trusts are not making this available now is not because of Choose and Book, although it might be something convenient to hide behind.'

Dr Richard Vautrey, GPC

negotiator, called on the Department of Health to be 'open and honest' about restrictions caused by waiting time targets.

He said: 'Either accept there is rationing going on, or patients have the right to full